Optimal criteria for transcatheter closure of Fontan fenestration: a single-center experience with a review of literature
| Autor: | Daisuke Kobayashi, Yuki Kawasaki, Thomas J. Forbes, Takeshi Sasaki, Robert D. Ross |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Heart Defects
Congenital Cardiac Catheterization medicine.medical_specialty medicine.medical_treatment Hemodynamics 030204 cardiovascular system & hematology Fontan Procedure Single Center 03 medical and health sciences 0302 clinical medicine Occlusion medicine Humans 030212 general & internal medicine Retrospective Studies Cardiac catheterization business.industry Retrospective cohort study Odds ratio Vascular surgery Cardiac surgery Surgery Flavin-Adenine Dinucleotide Cardiology and Cardiovascular Medicine business |
| Zdroj: | Heart and Vessels. |
| ISSN: | 1615-2573 0910-8327 |
| Popis: | Fenestration closure is considered to remove the persistent right-to-left shunt after the Fontan operation. However, the criteria for effective transcatheter closure of fenestration to avoid both acute and chronic Fontan failure have not been clarified. The objective of this study was to describe the hemodynamic data with test occlusion of the Fontan fenestration for patients who underwent a closure and those who did not, along with subsequent development of Fontan-associated diseases (FAD) at follow-up. This was a retrospective study conducted to assess the outcome of Fontan fenestration closure at Children’s Hospital of Michigan over 27 years (1993–2019). The inclusion criteria were patients undergoing cardiac catheterization indicated for Fontan fenestration closure. Data were compared between the two groups: closure and non-closure patients. Baseline characteristics and hemodynamic variables with the fenestration occlusion test were analyzed. The primary outcome was the development of composite events of death/transplant, deteriorated New York Heart Association class symptoms, or FAD. Among the 38 patients who were brought to the catheterization laboratory, 33 received fenestration closure and 5 did not. On a median follow-up of 3.4 years (range, 1 month–12.6 years), the incidence of primary adverse outcomes was 13% (5/38). The incidence of primary outcome was significantly higher in the non-closure group (60% vs. 6%, p |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink